Asthma question

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Medic29

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Stupid question here:

If someone is having an asthma attack and they have no rescue inhaler, is it possible to help them till 911 gets there by mouth to mouth? Barrier used obviously
 
I guess it would be possible but I wouldn't want to. You can do assisted ventilation with a BVM but ether way your going to be fighting them. So O2 NRB until it resolves or they pass out then back to the BVM.
 
I would punch you if you tried to do mouth to mouth on me when I was having an asthma attack and was not unconscious. Seriously. The last thing I want is someone in my face.
 
Aidey said:
I would punch you if you tried to do mouth to mouth on me when I was having an asthma attack and was not unconscious. Seriously. The last thing I want is someone in my face.
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What she said.

It's hard enough to get breathers to keep a NRB on their face while you're getting a neb ready. If they've been through it they understand but if not it can be a pain in the butt.
 
Not very effectively if at all. The issue is bronchoconstriction and increased mucus production. PPV won't open the bronchioles back up very much. I imagine with enough pressure they will open up at least a little, but the far end of that would be air trapping as there would be minimal expiratory pressure to keep them open.

I may be off my rocker, but that's how I think of it.
 
The issue is getting air out more than it is getting air in. So no, mouth-to-mouth / barrier really won't help and in fact could exacerbate the issue.



If you've never experienced air trapping, you have no idea how much it sucks.
 
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With Linuss all the way. And don't try all the home remedies like ...well, I'm not going into it. Talk to their doctor. And don't delay getting help, asthma is a killer and takes minutes to get going far enough along that nothing via the airway will be of use.
 
Linuss said:
If you've never experienced air trapping, you have no idea how much it sucks.
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Sucks a lot! Especially when it happens in the shower :( :(

It's worse than not responding to PM's
But Linus did hit the nail on the head, when someone is having an asthma attack, they are having trouble getting air out of their lungs, not inhaling.
 
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mycrofft said:
With Linuss all the way. And don't try all the home remedies like ...well, I'm not going into it. Talk to their doctor. And don't delay getting help, asthma is a killer and takes minutes to get going far enough along that nothing via the airway will be of use.
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This. I almost died when I was 12 from an asthma attack. I ended up hospitalized for six days. I'll tell the story some other time.
 
The issue with asthma is getting air out, not in.

When the patient breaths in, the chest wall expands creating a vacuum in the lung passageways causing them to actually expand enough to allow air flow.

When the patient breaths out, this same effect does not take place and with the broncho-constriction, inflammation and excess mucus in the way the "stale" air becomes trapped in the lungs.

With the old air in the way, it becomes hard to take in new air as well but mouth to mouth won't help that.
 
I asked cause I had a lady nearby at an apartment complex about a week ago who had an attack. And instead of calling 911 she drove herself to the hospital 3 miles away (long ways in Denver compared to the fire station 4 blocks down) and died at the hospital. Someone asked if she should have driven I told them no. Even if she thought it would be quicker.
 
Spot on. Panic sets in as does anoxia, and judgement goes out the window.
 
adamjh3 said:
Not very effectively if at all. The issue is bronchoconstriction and increased mucus production. PPV won't open the bronchioles back up very much. I imagine with enough pressure they will open up at least a little, but the far end of that would be air trapping as there would be minimal expiratory pressure to keep them open.

I may be off my rocker, but that's how I think of it.
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That was my understanding of it. It is also why I wish my company would put nebs on our BLS ambulances. They work well and can make a serious difference if the patient does not have his or her inhaler. Many of my IFT patients have asthma but don't travel with an inhaler, yet requests for nebs fall on deaf ears.
 
Sounds like there are posters on this thread with personal experience of asthma attacks as well as experienced medics... so while we're on the subject, how about coaching the patient in pursed-lip breathing?

Or is this one of the home remedies to avoid?

You make fish lips and exhale through them. Or with lips closed in the center, exhale through the small spaces on either side. The idea is that exhaling gently against pressure "splints open" the airways. The danger is provoking a vagal response if it's not gentle enough.

The physiology has been better explained on this site before. I'm just wondering does it help anyone here?
 
GranolaEMT said:
Sounds like there are posters on this thread with personal experience of asthma attacks as well as experienced medics... so while we're on the subject, how about coaching the patient in pursed-lip breathing?
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Trust me, the patient will already, subconsciously, be doing that. It's a natural way for the body to try to do PEEP and you'll see it in most of your worse off respiratory patients, or your everyday COPDer.
 
Aidey said:
I would punch you if you tried to do mouth to mouth on me when I was having an asthma attack and was not unconscious. Seriously. The last thing I want is someone in my face.
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Agreed.

That's the last thing you need of your having an asthma attack & I would be really angry if you tries to do that to me during an attack
 
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